Résumé
Se presenta el caso de una paciente de 24 años que ingresa al Hospital Regional de Lambayeque con una gestación doble bicorial biamniótica de 34 semanas 4 días por ecografía de II trimestre, en cuya ecografía al ingreso se evidenciaba una imagen dependiente de placenta probable teratoma placentario. Es hospitalizada con diagnósticos: Amenaza de parto pretérmino, feto 2 en transverso. Habiendo recibido tocólisis y maduración pulmonar se culmina la gestación por cesárea por parto pretérmino, obteniéndose dos recién nacidos de adecuado peso para la edad gestacional con dos placentas y una masa sólida de tejido embrionario con cordón procedente de una de las placentas, cuya anatomía patológica concluye: feto acárdico amorfo, producto de una perfusión feto fetal.
Résumé
Objective: The present study was done to know and compare the incidence of congenital malformations in singleton and multiple births in our hospital & compare with other studies. Methods: A retrospective study done by collecting the data from parturition register from Jan 2008 to Dec 2011 (4yrs) from Cheluvamba Hospital attached to Mysore Medical College and Research Institute. Total number of the live births, still births, and abortions> 20 wks were collected. Details of multiple births such as maternal age, gestational age, sex & birth weight of the babies, U/S reports and congenital anomalies (CA) were noted. Results: The total number of singleton births were 48700 and number of babies who had congenital malformations were 235 (48.25/10,000 births).Total number of multiple births were 579 including 10 triplets and number of babies who had CA were 11 (189.98/10,000 births, P<0.0001). In the present study sex of the babies were noted in all multiple births and zygosity could not be recorded. Among 579 multiple births 404 were of the Same Sex (SS) and 165 were of Opposite Sex (OS) in twins and 6 were of the same sex and 4 were of opposite sex in triplets. According to Weinberg formula 50% of same sex (SS) twins are monozygotic and 50% are dizygotic twins. Among the 11 babies with CA, 4 monozygotic twins had anomalies related to twinning such as Acardia with TRAP sequence (3 twins), and Thoracophagus (1 twin).5 babies had CNS anomalies, 1 with cystic hygroma, 1 baby with multiple system affected. Conclusion: The incidence of birth defects is more in multiple births and especially in monozygotic twins. In the present days increase in twinning rate due to advanced maternal age, hereditary factors and use of ovulation inducing drugs, which results in premature and low birth wt babies associated with poor lung maturity.
Résumé
Se presenta el caso de una paciente de 23 años de edad, procedente del Estado Barinas, II gesta, la cual presenta un embarazo gemelar monocorial, donde el primer feto tuvo desarrollo normal y falleció por dificultad respiratoria en el período neonatal y el segundo, fue un feto acardio anceps. Al examinar el feto se observó ausencia de corazón y pulmones, cerebro rudimentario y anomalías de las extremidades. La disección reveló epidermis con abundantes células vacuolizadas, dermis edematosa y ausencia del epiplón mayor. Los genitales externos femeninos estaban bien desarrollados. El examen radiológico mostró un cráneo pequeño, osificación de columna vertebral y anomalías óseas de manos y pies. Se hizo una revisión de la literatura sobre acardia en los últimos 30 años
We presente the case of a 23 year old patient, from Barinas State, II gravida, with a twin monochorial pregnancy, a normal fetus who died for respiratory distress in neonatal period and the other one, was an acardio anceps. The acardius presented absence of heart and lungs, a rudimentary brain, and anomalies of extremities. The dissection showed epidermis with numerous vacuolized cells, edematous dermis and absence of mayor epiploon. The external female genitals were well developed. Radiological screening showed a rudimentary cranium and anomalies of the hands and feet. We reviewed the last 30 years of acardia literature